Onset and Development

Stuttering typically begins between the ages of
2 and 5 years. Some children show signs of stuttering as young
as 18 months or show no signs until the age of 12 or 13 years.
Many children go through a stage of development during which they
repeat words and phrases, draw out sounds, or have other dysfluencies.
In most cases, this "stuttering" is considered normal
dysfluency. For some children however, seemingly normal dysfluencies
are actually signs of early stuttering.

Stuttering is a developmental speech disorder, beginning in early
childhood. In about half of all cases it begins gradually over
the course of many months. In the other half of cases the stuttering
begins suddenly, within about two weeks. Early stuttering may
not progress smoothly. Rather it comes and goes in cycles. Left
untreated stuttering may become more severe over time. Here is
a list of common behaviors associated with stuttering. This list
is often known as the "Eight Danger Signs of Stuttering."

Part-word (syllable) repetitions,
usually the first syllable of a word, such as "da-da-da-daddy."
(click here for example of repetitions)

Substitution of the "schwa" or weak vowel in
a repetition,
instead of saying "bay-bay-baby", the child may say
"buh-buh-baby."
(click here for example of schwa vowel)

Prolongation of a sound
or holding onto one sound for a longer time than necessary, such
as "mmmmommy."
(click here for example of
prolongations)

Tremors,
uncontrollable movements of the jaw, lips or tongue when speaking
dysfluently.
(click here for example of tremors)

Pitch and Loudness rise,
when repeating or prolonging a sound, pitch and loudness may
increase.
(click here for example of pitch/loudness
rise)

Struggle and tension,
visible difficulty getting the word out; this may include but
is not limited to eye blinking/ movements, facial grimaces, lip,
limb, or torso movements.
(click here for example of struggle
& tension)

Moment of Fear,
a brief, fleeting expression of fear when approaching certain
words or sounds or during a moment of stuttering.
(click here for example of moment of
fear {no sound on this one})

Avoidance,
unusually long or an unusual number of pauses, avoidance of certain
words or of speaking altogether, postponing a word until the
child can say it smoothly.

Many different theories and models have been proposed to explain
how stuttering develops. Some of the same features cut across
these models and theories. The characteristics listed here were
compiled from a variety of theories and represent most types of
behaviors seen in people who stutter. Not all people who stutter
will exhibit all of these behaviors.

Stage One
Normal Dysfluency (ages 2-6)

Speech and language are difficult and complex skills to learn.
Almost all children have some difficulty in developing these
skills. This results in normal dysfluency.

Dysfluencies tend to be single syllable, whole word, or phrase
repetitions, interjections (um, uh), and revisions.

The child may have up to 7 dysfluencies per 100 words, and
no more than 3 stuttering-like dysfluencies per 100 words. Stuttering-like
dysfluencies are part word repetitions, prolongations, and blocks.

Brief pauses as the child is planning what to say are normal.

The child will not exhibit visible tension, frustration or
anxiety when speaking dysfluently.

Normal dysfluency will occur when the child is learning to
walk or refining motor skills.

There are periods (days or weeks) of fluency and dysfluency.

Changes in the child's environment can cause normal dysfluency.

Stage Two
Borderline Stuttering (ages 2- 6)

Dysfluencies tend to be repetitions and sound prolongations.

The child may have more than 7 dysfluencies per 100 words
or more than 3 stuttering-like dysfluencies per 100 words.

More than two dysfluencies put together (e.g., myyyyyyyy-my-my
pup-pup-py).

There are periods of fluency and dysfluency which come and
go in cycles.

The child demonstrates little awareness or concern about
his/her dysfluencies but may express frustration that her/his
message won't come out.

Stage Three
Beginning Stuttering (Ages 2-6)

The child may have more than 7 dysfluencies per 100 words
or more than 3 stuttering-like dysfluencies per 100 words.

Dysfluency most commonly occurs at the beginning of words
or phrases.

The child tends to be more dysfluent when excited or upset,
seems to have a lot to say, or when under some type of pressure.

Repetitions are usually part-word as opposed to whole-word,
and involve the schwa ("uh") vowel.

The stuttering comes and goes in cycles, sometimes triggered
by events and stressors, sometimes not.

The child may show awareness that speech is difficult in
addition to the frustration of not being able to get a message
out easily.